S7E16: Prioritizing Wellness and Balancing Life Outside of Medicine

Lilly: Ha and I had this conversation a couple weeks ago about the joys of a new workout set. And I know that you both can kind of relate to this, but I recently got into running and I literally justified it to myself that I deserved a new workout set. And it was a matching set. I went a little crazy.

Hạ: What color?

Lilly: It's like a muddy brown beige. I don't want to say diarrheal giardia color, but it kind of looks like that.

Well, as we kind of talk about workout sets, I'm so excited for today's topic. But before we dive in, as usual, I just wanted to do a quick disclaimer that all the views that we share here on "Bundles" do not reflect the views of our employers or the institutions that we are associated with.

So once we've gotten that out of the way, I'm really excited to introduce Ha, which you already all know is one of our lovely co-hosts here on "Bundles."

Hạ: Hello.

Lilly: Sorry, I always forget to pause.

Hạ: It's okay. You're just always super excited. It's the Lilly energy.

Lilly: It's just a chaotic energy. But I'm really, really excited because we have a guest, one of my classmates, Cassidy, and I want you to introduce yourself and tell Bundles a little bit about you.

Cassidy: Hi, my name is Cassidy. I used to be in Lilly's class, but I took a year off to do a research fellowship at UT Austin, and so I'll be joining the class of 2025 next year. Thank you so much for having me today.

Lilly: I still count you in our class.

Cassidy: I do too.

Lilly: But I'm really excited because I wanted all three of us to chat today a little bit about wellness and life outside of medicine. And I felt like who's the best people to bring on here besides people who have really helped me embody that all through med school. So thank you all for being on this episode with me.

We always hear doctors and healthcare professionals telling us that exercise is really important to our overall health and well-being. And a lot of times we kind of want to roll our eyes because we're like, "Oh, we know, but we're so busy."

And I was looking at some stats. It was kind of interesting. According to the CDC, heart disease and stroke are two of the leading causes of death in the United States. And getting at least 150 minutes a week of moderate physical activity can put you at a lower risk for these diseases, which is really interesting because obviously none of us want to have that as we get older.

But I also learned, reading a little bit more into exercise, that it can improve the thinking and cognition for children between the ages of 6 and 13, which I think is super important to people like Ha who are these aspiring pediatricians in our field.

But for me also, I thought it was interesting to learn that exercise can reduce short-term feelings of anxiety in adults. So I really wanted us to kind of talk about this and really discuss why it's so important to have wellness in medicine. And I just wanted to get your two thoughts about these stats and what you all think about them.

Hạ: Whenever I hear certain stats, like when I heard you say those stats, Lilly, I just immediately thought, "Oh, it makes so much sense." For instance, when you were talking about anxiety, I feel like when I'm able to have a good fitness routine and I'm exercising at least five days a week, I feel a lot better and I feel like a lot of my anxiety and my mood is in much better control.

As someone in medicine, I always like to look at the evidence and all of that. And so it's cool to see that studies show what we all deeply feel.

Lilly: What are your thoughts, Cassidy?

Cassidy: Well, at first seeing these numbers, it's super daunting, I think, for people who might not be as familiar with exercising every week like we are. But if you put it into perspective, that's like two and a half hours of a show. And I feel like we could totally binge that very easily.

I feel like the first response I get when I say I work out three to four times a week is, "How do you do that? How do you have time?" But we have time to sit down and watch a show for that long.

I do feel like that I feel less anxious ever since I started working out more, and I do feel like these stats may be very daunting at first, but it definitely correlates in my life. And I do see parallels that it does improve my thinking and cognition.

Definitely when I'm stuck not knowing what to do with my work, taking the time to exercise and take a refresh definitely helps to put me back on track, even though that sounds kind of like reverse thinking. Why would taking time to do exercise help you? But it definitely feels like I'm more efficient with my work after. I feel rejuvenated and energized, and seeing my friends during my workouts, like Lilly and Ha, talking through things with people outside of medicine, it definitely has helped me to grow as a person, as a physician, and help reset my mind.

Lilly: I remember this quote as you were talking, Cassidy, about you never regret a workout after you've done it. And I think that's so true because even though the buildup and having to take that time out of your day and thinking, "Oh, I could maybe use this to do an extra set of questions or chart review for tomorrow," whatever it might be, and you feel like you're adding this extra burden to your day, but every single time I've worked out, as soon as I'm out of that workout class or out of the gym or whatever it might be, I feel 10 times better. I do feel a little bit more rejuvenated, which I felt like you were also hitting on. So I definitely agree with that.

And I just feel like as med students in general, we have a lot of guilt around taking time for ourselves and having wellness in our personal lives. I remember during first year in the COVID year, I felt like any minute I wasn't sitting at my computer studying for didactics was a minute wasted.

But then I also realized I was spending triple the amount of time that I actually should have on studying because I was so tired and stuck in a rut. And as soon as I started working out, I felt like just leaving the space and coming back really helped me see things from a new perspective, have a better understanding of whatever topic it was I was studying, and overall put me in a better mood. And I think that's the tricking your mind that Cassidy was hitting on as well.

I just wanted to hear a little bit more from you, Ha, first, and then Cassidy, about what kinds of wellness activities you all have been able to integrate into residency/your research year/in med school that you really feel like helped you explore your hobbies and have better lifestyle options outside of just studying all day.

Hạ: It was really funny, Lilly, when you were talking about how it was kind of a cost-benefit analysis of time and when to exercise, because I would say I was a bit late at jumping on the wellness and exercise bus.

I did start working out a little bit during the COVID years because we were just stuck at home for a good chunk of it. But I didn't get super into thinking about my wellness and working out until actually you started inviting me to go cycling with you at Torrent.

I still remember the first time I went. I think it was because it was for your birthday or something, so I felt compelled to go. I was there and I was like, "This feels like a cult. I don't know how I feel about this situation." But it made me feel so good, and you also kept inviting me. And so it forced me to start getting out and start moving a lot more.

This has been something that I've now tried to integrate more as a resident. And sometimes with residency, you have long hours and there are just some days where you leave work and you're like, "I don't know if I'm up for this workout or to go on this run," and you choose to do other things for wellness, like watching TV.

It's actually funny, Cassidy, that you were talking about watching TV versus exercising. And I was actually going through that debate earlier, this very moment, getting out of clinic.

And so sometimes it is that kind of weighing. You're so limited in time because often, and this is the case in medical school too, you work six days a week a lot of times. You have other things to do with life, and in medical school, studying, other activities. And so you have to kind of weigh in what to do with the limited time that you do have that's free.

Sometimes it means I might not exercise every single day a week, but I try to put some movement in during the day. And if it's a day that I've chosen to not exercise, then I find other wellness activities, like reading a book.

I've recently gotten into audiobooks a lot and reading again and re-finding that joy that I didn't have for a while. But it is really hard, so we just give ourselves grace and we do what we can to make ourselves feel like we fill our cups.

Lilly: I love that. What about you, Cassidy?

Cassidy: Just going into how I started working out, it was back in probably the sixth or seventh grade, my mom introduced me to Bikram yoga, and I did not like it one bit. It is so hot in that area. It's like 100 degrees or something, I swear. I was so fatigued.

But then getting out of the room, that breath of fresh air, it reminded me how often do we not think about all these little things that we get to experience, like the joy of a breath of fresh air. And some people might not have that opportunity.

I mean, that's what really ignited my passion for exercise at first, was being able to connect with my mom, have our relationship grow through working out with her.

And through that, I started working out more in high school and she introduced me to her trainer. I think definitely getting those accolades and those cheers from a trainer, it really helps to push you to get that extra pushup in, that extra rep in. It was something outside of academia that I could do well, and it made me feel a lot of pride and joy.

And so I felt like college was when I was trying to make friends and do my clubs and stuff. That was super fun to delve into medicine more through medical clubs and whatnot.

But I think inviting my friends to take a workout class and finding our passion for working out together was what really created strong bonds with me and my classmates.

And obviously, Lilly continued that joy for me in medical school by inviting me to cycling with Ha as well. And I resisted going to Torrent, but I ended up really enjoying and finding my family there.

I definitely agree with Ha and Lilly that it's like our second family outside of medicine. So much of our personality is just centered towards medicine that we forget that there's something outside of us, an outside Cassidy or an outside Lilly or Ha. We're not just doctors or going to be doctors one day, but we have a personality outside.

And medicine is just so tiresome sometimes. I was even thinking about it today. How many lunches did I get that I didn't have to go to a didactic session or get to actually enjoy my lunch and not figure out how many minutes I have to eat all this food before I have to go back and do my chart review or see my patient.

So taking that time for yourself. I think it's so important to realize your time is important, but the time you take to clear out your mind through exercise is really valuable. And I think without it, I wouldn't have been able to get through medicine, get into medical school, and even continue my research fellowship.

Today, I'm constantly working on the computer, seeing patients. Having that time to take a refresh and get back into it, that's how I keep pushing forward. And people think it's a little crazy, but I think that's what keeps driving me to achieve and do better in my life and in medicine.

Lilly: I love that. I loved both of those perspectives of starting out your wellness/fitness journey later on in life, which is something similar to my story, versus also having it just be integrated early on and how you've continued to be able to grow on that, Cassidy.

Also, I just want to give a shout out to your mom because she is a boss lady dentist who goes to yoga three times a day. I mean, she's just who we all aspire to be.

Cassidy: I know. I can never do what she does. I definitely do not have the strength that she does. In yoga, rain or shine, New Year's, Christmas, it doesn't matter what holiday, she's there at 6:00 a.m. and then goes to work and sees patients from 8:00 to 5:00, and then comes home and is a mom to us. It makes me super proud, but it also goes to show how much strength you get from just working out and how it builds your mental strength.

And I think that also parallels with how we're able to sustain ourselves during these crazy exams that we're taught to do normally. It's expected that we take a 9.5-hour exam as a physician, but is that even humanly okay if you don't even sleep for that long?

Lilly: The traumas of Step 2.

Cassidy: Not to diverge.

Lilly: No, please.

Hạ: And I think one of the things that I reflect on a lot now that I'm in residency, and it was something I was starting to think about as a medical student, but really I've solidified a bit more, is just really recognizing . . . and you alluded to it, Cassidy. Uncoupling your identity away from medicine.

I feel like for us to get to the point that we get to, we always have to make medicine essentially a calling and a big part of who we are. And it is a big part of who I am, but my belief is that it should be the least interesting part of who I am.

I was talking with some second-years about it. They were telling me one of the things that helped them rethink their perspective is that if they were gone, medicine, the system, would still keep going. And so we don't really want to lose ourselves to medicine.

And the work of being able to get more into exercise and really thinking about wellness and with residency, I've been working a lot on uncoupling, doing that, and recognizing that I'm trying to build an identity of myself that's outside of medicine.

And ultimately, I feel like that helps a lot more with our wellness, too, and our ability to get through the day when we realize there's just more than the work that we do, especially when the workday is really, really rough and you're sitting there going, "Oh, no, I messed up on something." Not speaking from experience.

Lilly: That really struck a chord with me, Ha, because you hit on a couple of things. One of them reminded me of interview season when people would ask, "What hobbies do you have, or what do you enjoy doing outside of medicine?" And my immediate response would be like, "Well, I would hope that being in medicine is the least interesting thing about me."

I wanted that to be what they emphasize, as opposed to "What do you fit in with your big doctor life?" as opposed to being like, "Oh, how are you a whole person?" and medicine is just one portion of that pie. And so I really like that you both hit on that.

I think that that's something that's really hard for people who are maybe pre-med or pre-healthcare professional, and you're just trying to churn through the system and get all of those things done. But it's really important to be a well-rounded person and to have hobbies and interests of your own that don't really impact your application, because that's what makes you, you.

And at the end of the day, that's what people want to see, because that's who they'll be working with, not your resume or your application, which I think is really important to know, especially since we're constantly working through this system where we have to check all those boxes.

And then hearing Ha speak about the resident perspective also makes me think a lot about resident wellness and mental health and the recent loss of Dr. William West, which I'm always thinking about his family and his community. It just continues to highlight how important it is that residents feel supported and that they have community around them.

It's really interesting, because when I talk to my friends outside of medicine, when they're getting recruited for jobs, they will talk about how certain companies pay for their gym membership, or pay for them to have some type of wellness activity a part of their contract, or they'll have some kind of social wellness something going on that you're able to participate in.

Even certain apartment buildings have monthly activities they do for residents to get them out of their units and interacting with others. And I just think it's interesting, because going through the process of interview season, people talk about wellness, but I really wonder how they propel that and really implement it.

It's great to hear that we have a wellness office, but it'd also be really nice to get the day off to be able to sleep in and take a workout class or go walk outside and get some real vitamin D and practice all the things that we preach to our patients. So that made me think a lot of things, and so I appreciate you sharing that.

As far as my perspective on how I got involved in wellness/exercise, it's actually really embarrassing. I was that person who walked the mile in high school. I'm pretty sure I got a 17-minute marker on that, which I don't think you can graduate with that, but whatever. I definitely did not run that.

And then going through college, I was definitely that student who opted for Red Bulls over meals, and I had more all-nighters than I could count. I thought if I stayed up all night, took my test, I could crash when I got home, which was not sustainable in med school and definitely was not something I was able to do once I was actually in didactics. But that was how I conditioned myself through life, was just getting to that next step.

And I really started to notice in my first year of med school that I was really impatient, I was easily agitated, I got really stressed, and I was always, always, always tired. Even if I slept for 10 hours one day, I'd wake up and I'd be really exhausted.

I was just stuck in this sort of hamster wheel of continuing to make it through, thinking that this was just like undergrad and I just had to get through finals, not realizing that every other week in med school feels like finals. You have a big quiz you have to study for. You have an entire unit worth of material you need to study.

There's this meme of people screaming into a pillow after their test is over, and then they sit down at the computer and they're like, "Time to start studying again." And that's truly how I felt in med school.

And so for me, I started to notice that as precautions for COVID started to lift and people started going out more, I wanted to get more into fitness. I also did not have really any friends in med school because I just sat at my computer at home all day and that was the best way for my awkward social self to be able to socialize.

I was like, "Oh, we'll go to a workout class and then we'll chit-chat a little bit afterwards. And if it's awkward, at least we got a workout out of it." I was able to convince people to go with me, and that was how I was able to cultivate friendships with Ha and Cassidy and so many others.

And a lot of people would tell me, "Lilly, the only way I can hang out with you is if I work out with you." And I was like, "That's great, though. Let's do that." And then through that, I felt like we were able to create these meaningful friendships where we're still staying in touch even when we're miles apart, which is really sad to me because I miss you guys.

I guess, for me, my big way of really practicing wellness is through exercise. As someone who absolutely hated it, now I'm really impressed that I'm able to really consistently work on this.

But there are also ways to build community and practice wellness outside of exercise and physical activity. So I also wanted to hit on that and ask Cassidy first and then Ha, outside of your typical workouts, what are some ways that you're practicing life outside of medicine? What does that look like and how does that really impact you?

Cassidy: I think building community outside of medicine . . . I really enjoy finding new restaurants and places to hang out at with my residents right now that I'm working with or the friends that I meet now that I've moved to Austin. I think it's just really cool to try new foods and new experiences that I wouldn't be able to experience in my own city or previous places I've traveled to.

And also just to have a really good time outside of medicine, doing something that everyone can enjoy, which is eating, obviously. But also going to the farmer's market or going to a park, just taking a stroll through the community, you just see so much life outside of medicine.

It's funny, I recently saw a TikTok where a med student goes through their accomplishments for four years versus someone outside of medicine, and they've started a family and they've gotten a new job and all these crazy things.

It just puts things in perspective that our life outside of medicine, as we keep reiterating, and how we find ourselves as a person, that medicine should . . . At the end of the day, it's sad to say, it is a job even though we do take it very seriously and that it's a calling.

And so those are some ways that I find outlets for my stress and building community outside of medicine. But along with that, I think just taking some time to de-stress. I don't know. It sounds really crazy, but I recently got into taking baths, just Epsom salts . . .

Lilly: Love that.

Cassidy: . . . and reading a book or just laying there and thinking through the day. It's so crazy how we put ourselves through so much for this job. And so those are just some ways that I de-stress and build community outside of medicine.

Lilly: I knew you were going to say food. I love that.

Hạ: Retweet on the food thing. But yes, I similarly also build community by doing food hangouts. I love going to restaurants or grabbing boba or coffee shops. I also love breweries and stuff like that. So I feel like I like to go out.

But other things I enjoy just doing is hanging with people at a picnic is fun. I love being outdoors, so I like just getting to do stuff outdoors as a way to cultivate wellness, finding fun activities to do together.

A couple of my co-interns and I, we're trying to learn how to roller skate. Roller skating is kind of big in the Bay Area. So I bought a pair of roller skates and I've been slowly learning my way through, and that's really fun.

Since moving to SF and having to remake a new community, I downloaded Bumble BFF and I've been meeting people through Bumble BFF, much more success than I feel like [inaudible 00:23:53], but it's been really fun. And what's really cool is I meet people from all different walks of life and different experiences.

And it's also really nice because when I interact with people who aren't in medicine, it reminds me there's so much more to the world than this little bubble that we live in and it re-centers me.

So it's just making time to do those little things day by day, like watching a Netflix show, reading a chapter of a book, going through my audiobooks, which I'm doing really well. Libby, y'all. If you guys have a library card, I have a plug for Libby. You can just get it, and it's free audiobooks checked out by your library.

Lilly: The best. I love that. And I felt like you hit on something really important that I also wanted to talk about, which is that wellness and hobbies don't have to be expensive. You don't have to break the bank for them.

Obviously, some of the things that we discussed today might not be accessible to everyone, like fitness classes or being able to access certain different gyms and memberships and stuff like that. But some of the stuff that I like to do also is spending time with my friends and family, which you both discussed, especially since my family lives out of state. I love traveling to see them, being there around the holidays and just honestly rotting on the couch with my mom and just catching up.

I really like walking around the park as well. My dogs really like that too. So it's mostly for them as well, but then I get some fresh air and get to see the sunset, which is really nice.

And then one thing I picked up, which I'm definitely not the most talented in, but during third year, I started to go to a pottery studio and started taking pottery classes to learn how to make my own matcha cup and mixing bowl and that kind of stuff. It was kind of funny. I tried to make a ramen bowl and it ended up being the size of a mug. But we were still trying and we were having fun. That's all that matters.

Hạ: Lilly is diminishing her talent. She's very good at pottery. All of her pottery stuff looks really great.

Lilly: To be fair, though, it was mostly just for fun and it was a way to get over imperfectionism in me. I really think that everything needs to go the way I want. And in pottery, sometimes you think you're going to make a cup and you just end up making a plate or you end up making the opposite of what you wanted. It's really frustrating and I get really pissed off. But then you just sit there and are like, "Well, I paid for this clay, so I might as well make it into something nice." But it's been a fun outlet.

Something that I think a lot of people in our class actually really enjoy, and I think this is probably a COVID kid issue, but we all have some kind of weird plant obsession where everyone has some kind of child plant that they took care of during quarantine that they're very connected to. And one of my big things is keeping them all alive now because I've made this investment in them. So that's been kind of fun seeing new leaves pop up.

But anyway, all of this is just to say that you can really pick anything that you're passionate about that takes you outside of whatever you're studying and whatever you're focusing on to remember that you're a whole person and that the world continues to turn.

I think Cassidy hit on this as well and so did Ha, about when you leave the hospital, the hospital will continue to run. It'll continue to function whether we're there or not, but the impact that you made on those around you and the way that you experienced your life, that's only going to really matter to you.

But as we kind of wrap up this episode, I'm so appreciative that two of my besties could come on here and chat with me about things that we really get a lot of joy out of that honestly really kept me going in med school and helps prevent burnout.

It's just highlighting how important it is to have a life outside of medicine. It helps you be more well-rounded. I think it's the one thing you can truly do for yourself outside of caring for others. And it's an investment in your body.

I mean, your brain fully develops when you're 25. And what is it? The most muscle mass you'll have is by 35 or something like that. These are all things that you kind of have to invest in early on in order to maintain as we get older.

And so those are important things to do just for your own body because it's the only one that you get and it's the only one you get to walk around in.

And then lastly, Ha mentioned this, but being gentle and having grace with yourself. And if it means taking the night off to just lay in bed and watch Netflix while you eat Doritos, that's totally okay too and we're all allowed to do that.

Anything else you all wanted to add as we kind of wrap up this episode?

Cassidy: No, I definitely agree with you. I don't think we're crazy and we all love Netflix. We're not Netflix haters. I just want to put it out there. But we just constantly work out.

Like Lilly was saying, take time for your family and friends. That's just so important to me now that we're in this field where our time isn't really ours. We don't know when we get to leave the hospital.

It sounds so crazy, but I know that I have this hour with my mom or my dad and my sister, and so I want to make the most out of it and to just really appreciate those moments because we don't have that time. It's going to end one day, and as we continue progressing through our medical education.

And so I think Lilly really hit the nail on that one, appreciating what we have right now because it's the only time we'll get to be in this body and in this time period. To just really take things one at a time and sit down and smell the roses because you don't know when you'll get that chance again.

Hạ: Something that always centers me is when I really like think about, "What are the things when I go back and think about the past that I remember?" And it's not that score I got or me being impressive in this presentation or anything like that. It's all of the fun wellness activities. It was Yoga at the Capitol on Wednesday evenings with Lilly or being able to eat a really good food and being able to hang out with friends.

And I think that helps to center to really remind ourselves that there's just so much more to life, and there's so much more that is actually important to us, because those are the things that our brain, when it needs to make room for stuff, it made room for.

And also shout out to Lilly for creating a workout community and making me more healthy.

Lilly: People are going to see me they're going to be like, "You talk a lot about working out," but also I love to eat. So please make sure that you have a good balance.

I think that you both totally packaged that so well at the very end. And it reminds me of the last time we all got to hang out together. I don't remember all the hours I spent studying for my last shelf exam, but I do remember all of us getting mini doughnuts late at night when we were saying bye to Ha before she left for California. So I definitely agree.

And on that note, I just wanted to tell everyone to invest in themselves. Share with us online ways that you practice wellness. Or if you have any questions about how to do that and how to balance it, we're here and we're available to help you figure that all out.

Anyway, I just wanted to thank all of our sweet listeners for tuning in to this episode. Please send us any questions you may have and be sure to subscribe to our podcast, and listen to us wherever you podcast. We'll see you at the next one. Bye.

Hạ: Bye.

Cassidy: Bye.

Lilly: Yay. You guys like the sunset as we were talking? My room is so dark now.